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ISSN: 1734-4948
Advances in Rehabilitation
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4/2024
vol. 38
 
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abstract:
Original article

Bilateral transcutaneous tibial nerve stimulation: a promising treatment for women with postpartum constipation: A randomized controlled trial

Afaf Mohamed Mahmoud Botla
1
,
Marwa Shafiek Mustafa Saleh
2, 3
,
Walaa Salah Mohamed Ahmed
4
,
Saged Mohammed Elmazly
5
,
Donia Mohamed Moustafa Ahmed Elmasry
6
,
Manal Ahmed El-Shafei Mohamed
1

  1. Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  2. Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  3. Department of Physical Therapy, Faculty of Applied Medical Sciences, Al-Zaytoonah University of Jordan, Amman, Jordan
  4. Department of Physical Therapy, Quallin Specialized Hospital, Ministry of Health, Kafr El Sheikh, Egypt
  5. Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
  6. Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
Advances in Rehabilitation, 2024, 38(4), 16–24
DOI: https://doi.org/10.5114/areh.2024.144633
Online publish date: 2024/10/31
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Introduction
Postpartum constipation is a frequent occurrence of Cesarean section delivery. Although medications such as laxatives are effective treatments, they have widely-documented side effects and their benefits cease upon discontinuation. This study sought to examine whether bilateral transcutaneous tibial nerve stimulation (TTNS) could be more beneficial in treating postpartum constipation.

Material and methods
The study included 56 women, aged 20 to 35 years with a Body Mass Index (BMI) from 25 to 33 kg/m2, who complained of constipation after giving birth. The participants were randomly allocated into two equal groups and received 12 sessions of treatment. The TTNS group received bilateral TTNS, diaphragmatic breathing, abdominal muscle training, and behavioral therapy advice. The control group received the same therapy as the TTNS group but without the TTNS program. All participants were assessed at baseline and after 12 weeks through the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL), the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM), and the Bristol Stool Form Scale (BSFS).

Results
All outcome variables in both groups demonstrated a significant improvement after therapy compared to before (p<0.05). However, the final PAC-SYM and PAC-QOL scores were significantly more favorable (p < 0.05) in the TTNS group.

Conclusions
When treating constipation in postpartum women, adding bilateral TTNS to traditional physiotherapy treatment might be better than using traditional therapy alone.

keywords:

Postpartum period, Constipation, Transcutaneous tibial nerve stimulation, Diaphragmatic breathing, Abdominal muscle training










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